Symptoms of infective endocarditis (IE) and myocarditis are usually nonspecific and include fever, apathy, and loss of appetite. This condition can lead to severe heart failure with ascites or/and fluid in the thoracic cavity or/and in the pericardial sac. We describe infective endocarditis and myocarditis in 3 dogs and 4 cats. In all animals, the initial diagnosis was performed on the basis of a focused cardiac ultrasound examination performed by a general practitioner after a training in this technique. The initial findings were confirmed by a board-certified specialist in veterinary cardiology. Post mortem positive microbiological results from valves were obtained in 4 of 7 patients. Methicillin-resistant Staphylococcus aureus was confirmed in 2 cases and Staphylococcus epidermidis was confirmed in 2 cases, one of which included Enterococcus sp. coinfection. Histopathological examination confirmed initial diagnosis in 5 of 7 animals. In the remaining 2 patients, the time elapsed from the onset of clinical symptoms to death was about 1 month and no active inflammation but massive fibrosis was found microscopically. This is, to our best knowledge, the first report of IE and myocarditis diagnosed in small animals using focused cardiac ultrasound examination. Therefore, we conclude that common usage of this technique by trained general veterinarians may increase the rate of diagnosed patients with these conditions.
Aims: Cardiac resynchronization therapy (CRT) is a treatment dedicated to patients suffering from heart failure and asynchrony of systole typically due to left bundle branch block (LBBB). The aim of this study is to analyse the safety of CRT device implantation in a large single-centre group. Methods and results: The retrospective analysis of 198 patients hospitalized in the Department of Cardiology, dr A. Jurasz University Hospital no 1 in Bydgoszcz, who underwent CRT devices implantations in two consecutive years (2015-2016) has been performed. Out of 198 patients, 136 underwent implantation of CRT de novo and 62 exchange of the device. Studied procedures included implantations of 121 (89.0%) cardiac resynchronization therapy defibrillators (CRT-D) and 15 (11.0%) cardiac resynchronization therapy pacemakers (CRT-P) de novo, as procedures of exchange were excluded from statistical analysis. Collected data included: reported complications, patients' basic clinical characteristics, comorbidities and details of implantation procedures. Development of any complication was observed in 43 patients (31.6%), out of whom 29 ( 21.3%) experienced one, 10 (7.4%) two and 4 (2.9%) three complications. Most of them were minor complications. Serious complications which included pneumothorax, mediastinal hematoma and cardiac tamponade were observed in 6 (4.4%) cases, there were no perioperative deaths. The occurrence of complications was significantly more frequent in females (OR , 3.45, 95% CI 1.37-8.71, p 0.008), was associated with prolonged procedure time (OR 1.11, 95% CI 1.04-1.20, p 0.003) and prolonged hospitalization time (OR 1.16, 95% CI 1.06-1.27, p 0.001). Conclusion:Overall, implantations of CRT devices are burdened with a substantial risk of complications, although the majority of them are minor and do not require subsequent surgical intervention. The risk of developing serious complications is low, accounting for 4.4%.
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